Early childhood caries

Early childhood caries, also known as nursing bottle caries, is a very common bacterial infection characterised by cavities that most often show up on a child’s upper front teeth but can also affect other teeth. It first shows up as white spots near the gum line. These spots are hard to see at first, but if caught early can be stopped from progressing into cavities. As it gets worse, they can look like brown spots, holes or broken teeth which will require more involved procedures to fix. It is very important to get treatment early to stop the decay from getting worse.

Causes

One of the most significant causes is when a child goes to bed with a bottle filled with milk or juice – anything except water. Bacteria in the mouth use these sugars as food, producing acids that attack the teeth. After many attacks, the teeth can decay. Nursing bottle caries usually affect children below the age of 6 years. If your infant falls asleep while breastfeeding, he is also at risk.

Symptoms:

• dull white area is seen along the gum line on the labial surface of the upper front teeth
• When you observe cavities involving the neck of the teeth in a ring like fashion.
• When the entire teeth is decayed with only black/brown root stumps

Treatment:

Preventive Treatment

Fluoride exposure in the form of child specific fluoridated toothpaste and mouthwash and fluoride application are effective means of preventing caries.

• Fluoride application : Professional Fluoride Application is indicated when the white lesion on the tooth surface is observed. It prevents the teeth from undergoing further demineralisation thereby arresting the progression of caries. Most commonly, solutions of 5% sodium fluoride varnish (NaFV; 2.26% F, 22,600 ppm F) and acidulated phosphate fluoride is applied. It is done in young children below the age of 6years.
• Pit and Fissure sealant : These sealants are plastic resin which are applied over the depression and groves of the occlusal table, which prevents the cavitation of the tooth. It is usually done in young primary and permanent teeth whether blackish discoloration is observed or not as a preventive therapy
• Diet modification : Since food habits play an important role in occurrence of ECC please go through the following food chart and monitor what your child eats.

Therapeutic Treatment

• Restoration : Restorations/Fillings are done when the cavity is confined within the four walls of the tooth.
• Crowns : crowns are done when the cavity breaks any wall of the tooth.
• Root canal Treatment : When the tooth is heavily decayed with the cavity touching the nerve, pulpectomy (root canal treatment) is advised following which a crown is placed to restore the functionality and the aesthetics of the teeth.
• Extraction : When the teeth are damaged beyond the stage of repair, with only root stumps remaining, extraction is indicated in such cases. If the child is very young the ideal eruption of the permanent teeth is facilitated by the use of space maintainers.